The human race is gradually losing its hearing - Telegraph.co.uk
If Nicole Russell could turn back the clock, she’d probably turn down the volume, too. In 2004, when she was seven years old, Russell picked up an Apple iPod, plugged in a pair of the standard white headphones, pressed play, cranked it up, and formed a habit she’d enjoy for ‘at least five hours a day’ for the next decade. She’d listen in the morning, on the way to school, during break, even as she fell asleep.
A few years later, she was in the car – listening to music, of course – with her father, Dave, when he told her to turn the volume down. ‘He was like, “Nicki, what the hell?”’ Russell, now 24, says. ‘It made me so embarrassed, I’d just say, “But it has to be this loud… it’s the only way I can hear it.” I didn’t know there was a problem then. I thought it was just me.’
Throughout her school years in California – where the problem was made worse when headphones, used with iPads, became mandatory for many lessons, as they are in some schools in the UK – Russell struggled to hear in class and spoke loudly, often resulting in being shushed, ‘which isn’t exactly great for self-esteem’. When she watched television, she would turn the volume up high and add subtitles, to help her follow.
Eventually, while at university in Boston, doctors diagnosed her with hearing loss in both ears, though for some reason slightly worse in her left, and said there could only be one cause: the excessive loud music.
‘I was told it had been accumulating over years, just getting worse,’ Russell says. ‘I didn’t want it to be true, but it was a relief to know and be able to change things.’
And change things she did. The volume came down; her awareness of noise went up. But the damage is going nowhere. She will have hearing loss for life.
In our increasingly noisy society, stories like Russell’s are becoming more and more common. The charity Action on Hearing Loss estimates that 12 million people across the UK currently live with hearing loss – roughly one in six of us. By 2035, they predict it will be one in five. The speed of that increase is particularly alarming for young people. A report by the World Health Organization (WHO) claims that nearly 50 per cent of people aged between 12 and 35 – or 1.1 billion young people – are at risk of hearing loss ‘due to prolonged and excessive exposure to loud sounds, including music they listen to through personal audio devices’.
It is a point the audiology community is keen to stress: the world we live in is louder than ever, particularly in busy cities, but many people are exacerbating the strain on their ears by constantly listening to music or watching videos on smartphones.
‘I’d like to say it was improving, but people just generally don’t know about safe listening levels, and in a culture where headphones are everywhere, that’s dangerous,’ explains Francesca Oliver, an audiology specialist at Action on Hearing Loss. ‘Biologically, our ears have not adapted to withstand the volume of noise most of us encounter – or subject ourselves to – almost every day.
‘For example, anyone using headphones should listen at less than half the maximum volume for no more than half an hour at a time, but how many people know that, let alone implement it? If you have a particularly noisy commute and turn the music up to hear it, try listening to it at that volume in a quiet room. It’s painfully loud. So imagine what that’s doing to your ears.’
There is nuance to the statistics, of course: genetic factors, such as mutations in inner ear sensory cells, make some people more susceptible to hearing loss – especially the age related kind. (It’s believed the causes of this are 35-55 per cent genetic.) But while much is still being done to tackle going deaf in old age, the focus of many audiologists has shifted to avoidable, noise-related hearing loss.
It is believed that everybody – from obvious cases such as musicians and construction workers, to the rest of the public (commuters, gym-goers, schoolchildren, hairdressers, drivers, toddlers, or anyone with a handheld device) – is in danger of damaging their hearing from overexposure to loud noises, more than ever before. ‘Another problem is that people are often quite reluctant to admit they have hearing loss, especially the young,’ says Oliver. Put plainly: the human race is losing its hearing.
Vincent Howard knows precisely how dangerous noise can be. In 2004, he was a 15-year-old heavy-metal fan – floppy hair, always on the lookout for a mosh pit – when he found himself standing directly beside a stack of speakers at a Motörhead gig in Birmingham. As the band warmed up, a crew member walked past the speakers holding a microphone, causing a brief but piercing feedback sound. Howard was directly in the firing line.
‘It almost knocked me over – I didn’t even see the rest of the gig properly,’ he remembers. At the time he saw the pain as a badge of honour, as much a souvenir of the gig as buying a T-shirt at the merchandise stall, but by the next morning, the high-pitched squall, the disorientation (manifesting in a lack of balance, and the perception of people talking ‘out of sync’) and the deafness were still there. Howard couldn’t hear silence. ‘Sign of a good show,’ he thought, trying to reassure himself – but now, almost 16 years on, he still can’t hear properly. ‘Some souvenir, huh?’
He tells me the story from behind his desk at the London Bridge branch of Hearology, a group of ear-care clinics he co-founded in the capital in 2015. Now 31, Howard is an audiologist. His traumatic experience at Motörhead all those years ago was eventually confirmed as tinnitus, a condition that’s believed to affect one in eight of us but is still largely mysterious, defined by a false perception of sound – usually a buzzing or static noise, but it can vary wildly – when there is nothing external causing it. By far the most common cause of tinnitus is prolonged exposure to loud sounds, and more than 90 per cent of sufferers also have hearing loss.
Having trained in the branch of science that would allow him to understand ears better, Howard is now on a mission to awaken the rest of us to the devastation that noise can wreak on humans – especially young people. Loud concerts are nothing new. But an appreciation of what could be lost by refusing to take care of ourselves when attending them is relatively recent. As are many other harmful factors. ‘Headphone culture’ hasn’t been a part of everyday life for long enough for scientists to entirely agree on how best to make it safe, or for thorough regulations to be introduced. It is only recently that ‘noise pollution’ has been considered alongside other environmental worries, too.
‘The thing is, it doesn’t take something like what happened to me to ruin your ears – you could be doing it without even knowing,’ says Howard. ‘I sometimes see people listening to music over the sound of the Tube, which is crazy because the Tube is already dangerously loud. People just don’t value their ears. We get our teeth checked all the time and see opticians regularly. But our ears’ – he gestures to his damaged pair – ‘we just neglect them. And once they’re gone, they’re gone.’
To understand what noise-induced hearing loss is, it helps to first understand the ears. You may not have given them much thought before – besides decorating them, wishing they were smaller or shoving things in them – but our ears are appendages of almost incomprehensible complexity, every bit as miraculous as the eyes.
The outer, cartilaginous part (known as the pinna) that we recognise as our ‘ear’ is unique to us: the shape, protrusion, size, it’s all matched with your height, head shape, everything that makes you ‘you’. Swap ears with your partner and you won’t be able to hear properly. Do what Vincent van Gogh did – cut one off – and you definitely won’t. They are your ears, and you have two for a reason.
Inside the ear are two muscles and three of the smallest bones in the body, encased within the hardest, the temporal bone, which is so dense it can make the inner ear almost impossible to biopsy. When sound waves hit the eardrum, vibrations move through these bones to the inner ear, the cochlea, where they meet 15,500 tiny hair cells, called stereocilia, which are divided into 3,500 inner hair cells and around 12,000 outer hair cells.
When sound arrives, these move, sending signals along the auditory nerve to the brain, which will instantly try to interpret what the sound is and where it’s coming from. These hair cells are crucial to what makes hearing loss so dangerous. Of course, 15,500 sounds like a lot, but compare it to the millions of photoreceptors in the retina or chemoreceptors in the nose and it is nothing. They’re also in extremely limited supply. At 10 weeks of foetal gestation, all 15,500 are created, and from that point on, for the rest of our lives, we can only ever lose them.
Still with me? Good, now picture a perfect, luscious lawn of grass – the kind you might find cordoned off at a National Trust property; each blade erect, pristine in every way. This represents your hair cells at birth. Ideally, all the grass has to handle is wind, rain and the occasional bird plodding over it. This is safe, low-level sound, such as people talking or music played at a reasonable volume. Once flattened by that sound, the grass, like our hair cells, springs back into place, ready for more.
Now imagine if someone walked across that grass. That’s like exposure to very loud music or machinery. If it occurs only for a short time, tufts might take longer to rouse themselves, a few might be bent, but they should, most of them, go back to normal in time. This is the feeling of your ears ringing after a party, say, before that sensation wears off by the next morning.
But what if you keep cutting across the lawn on that same path over days, weeks, months and years? What if some people scuff the ground with boots? What if somebody drives over it? Eventually, the grass will wear down to such a damaged state that it cannot recover. This is what happens with hearing loss: hair cells have been destroyed permanently, creating a gap, so sound waves have no way of getting to the brain. And there is no Miracle-Gro, there is no ‘getting used to it’: this hearing loss is completely irreversible.
As anybody who has ever fought with an elderly person over the volume control on a television knows, there are competing definitions for what constitutes ‘loud’, but fortunately audiologists, such as Oliver and Howard, have a more concrete answer: most agree the ‘safe sound threshold’ sits at around 80-85 decibels (dB) – typically somewhere between a vacuum cleaner and an alarm clock.
Where it gets more complex is when time is introduced. After eight hours’ exposure at 85dB, hearing is damaged. That’s fine, nobody listens to an alarm or hoover for eight hours (though it may give cleaners pause for thought). The scale is then exponential: each increment of 3dB doubles the pressure, therefore halving the safe exposure time. An iPod at full blast is around 100dB, the same as a nightclub or hairdryer, and similar to the Tube at its loudest. Just 15 minutes of that can result in hearing loss. (For the record, Howard says the parental adage of ‘if I can hear your music outside your headphones, it’s too loud’ is absolutely correct.)
Moving up the scale, a rock concert is around 113dB – though some groups, like Motörhead, proclaimed ‘the loudest band on earth’ for reaching 130dB in 1986, push it far more – meaning well over a minute can be dangerous. A pneumatic drill is harmful after one second. A gun blast is even quicker. Even gym weights crashing can reach 140dB, enough to give permanent damage in one go.
Sound, remember, is a force that can destroy more than ear hair cells. When a bomb levels a house, it’s sound that’s tearing those bricks apart. One of the loudest noises ever recorded, the 180dB Krakatoa volcanic eruption in 1883, didn’t just burst eardrums within 40 miles, it was heard as a rifle shot in Alice Springs, Australia, 2,233 miles away.
Slowly, governments and industries are starting to understand this information and legislate accordingly, but in reality, it’s up to us. ‘The simplest thing we can do is be aware of the noise levels of the environment we’re in, then act,’ Oliver says. There are dozens of free apps that act as sound meters (Apple introduced a similar feature on its watches last year), which instantly tell you the decibel level you’re experiencing. If you can control the level, turn it down. If you can’t, specialist ear plugs are cheap and easy to carry around.
At Howard’s clinics, experts see people of all ages – ‘from three to 103’ – who have all degrees of damage. Hearing loss in old age isn’t entirely inevitable, but it is common, and Hearology will cater for those patients. It is young people Howard is most interested in, however, and making hearing checks ‘cool’, rather than something associated with the elderly, is a part of that. He offers state-ofthe-art hearing tests, and can create custom ear plugs for anyone who needs them.
Will Harvey, one of Howard’s patients, now carries his pair everywhere. The 32-year-old Londoner is a violin player, who used to be in successful rock band Dry the River. He was at a concert a decade ago when he found himself a little too near the drummer. (Drummers themselves wear ear protection.) For a week afterwards he was hearing ‘a semitone different pitches in either ear’ as a result of the impact of the noise. The experience had scarred him.
‘My hearing basically went back to normal after a week or two, thankfully, but because it had messed with my understanding of pitch, the paranoia was agony,’ Harvey says. He now preaches ear health to everybody, and car ries a small, fairly cheap pair of ear plugs on a keyring everywhere. They filter, rather than block, music, so they don’t dull the experience of a gig. He also wears noise cancelling headphones on the Tube, even when he’s not listening to music.
Nicole Russell’s experience led her father, Dave, to try to do something about the cheap, potentially dangerous headphones that damaged her ears as a child. In 2014 he founded Puro Sound Labs, a technology company fighting noise-induced hearing loss. With children spending an average of 23 hours a week glued to a screen, normally wearing headphones, he appreciated the tech is easier to change than habits, so created headphones that are limited at 85dB (most smartphones have noise warnings these days, but it is easy to brush past them) and block background noise that might otherwise provoke them to turn the volume up further.
It’s the kind of advancement that, paired with education, could make all the difference. ‘I’ve gone from not caring at all, to having a scare, then being militant, to now – where I have a good understanding of precautions, without worrying too much,’ Harvey says. ‘But that’s because I know.’
It’s an attitude Howard hopes we might all adopt, with enough awareness about the risks: being educated, taking precautions, but not letting the threat of hearing loss dramatically alter our lives. He still goes to gigs and, like Russell, he still wears headphones. But the ringing in his ears, and slight deafness, is a constant companion.
‘I’m sort of glad it happened to me now, because it gave me this motivation to stop other people taking their ears for granted,’ says Harvey. ‘I really want taking care of your hearing to be seen as a totally normal thing. If it’s sunny, we put on sunglasses and apply sunscreen, but if it’s suddenly very loud, most of us do nothing. So we’re walking around in the equivalent of blinding sun for most of our day. It doesn’t make sense.’
The message is loud and clear – but is anybody listening?
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